{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:26Z","timestamp":1784557046034,"version":"3.55.0"},"reference-count":14,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Gonadotroph adenomas are the most common type of nonfunctional pituitary adenomas. However, functioning gonadotroph adenomas causing clinical manifestations are rare. We present the case of a 42-year-old man with an incidental finding of a pituitary gland mass. A pituitary MRI revealed a 3 cm macroadenoma, and laboratory investigations revealed elevated follicle-stimulating hormone (FSH) and total testosterone levels. A diagnosis of functioning FSH-secreting pituitary adenoma was considered, with possible concomitant luteinizing hormone secretion, given the elevated testosterone, prompting further evaluation. Testicular ultrasound showed bilaterally enlarged testicles, and visual field testing revealed a monocular superior temporal defect. Transsphenoidal resection of pituitary adenoma was the treatment of choice. Histopathology assessment confirmed the diagnosis of gonadotroph-secreting adenoma, with positive staining for FSH. Within the 12-week postoperative period, FSH and testosterone levels normalized, and the patient experienced significant improvement in vision, along with the resolution of macroorchidism. While functional gonadotroph adenomas are rare, patients can present with a wide range of symptoms that are often unnoticeable due to their slow development. Careful evaluation can help guide multidisciplinary management to achieve full remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Endocrine evaluation is indicated in all cases of pituitary incidentalomas to determine functional status.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Clinically functioning gonadotroph adenomas, while rare, pose a diagnostic challenge and require careful clinical evaluation.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Transsphenoidal surgery is the mainstay of treatment of functioning gonadotroph adenomas, with the involvement of a multidisciplinary team to achieve desirable outcomes.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-22-0322","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T12:39:33Z","timestamp":1710938373000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Clinically functioning gonadotropin-secreting pituitary adenoma"],"prefix":"10.1530","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-4041","authenticated-orcid":true,"given":"Noor","family":"Alnasrallah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Adan Hospital, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8609-2190","authenticated-orcid":true,"given":"Khaled","family":"Aljenaee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Endocrine and diabetes division, Adan Hospital, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"AlMurshed","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Anatomical Pathology\/Neuropathology Division, Sabah Hospital, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sulaiman","family":"Hajji","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Endocrine and diabetes division, Adan Hospital, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Endocrine","first-page":"289","article-title":"Testicular enlargement in a patient with a FSH-secreting pituitary adenoma","volume":"37","author":"Dahlqvist","year":"2010","unstructured":"Dahlqvist PKoskinen LODBr\u00e4nnstr\u00f6m T & H\u00e4gg E. Testicular enlargement in a patient with a FSH-secreting pituitary adenoma. Endocrine201037289\u2013293. (https:\/\/doi.org\/10.1007\/s12020-009-9302-z)"},{"key":"bib2","series-title":"Endocrinology and Metabolism","first-page":"237","article-title":"Epidemiology of Functioning Pituitary Adenomas","volume":"35","author":"Chin","year":"2020","unstructured":"Chin SO. Epidemiology of Functioning Pituitary Adenomas. Endocrinology and Metabolism202035237\u2013242. (https:\/\/doi.org\/10.3803\/EnM.2020.35.2.237)"},{"key":"bib3","series-title":"Pituitary","first-page":"111","article-title":"Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas","volume":"21","author":"Ntali","year":"2018","unstructured":"Ntali G & Wass JA. Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas. Pituitary201821111\u2013118. (https:\/\/doi.org\/10.1007\/s11102-018-0869-3)"},{"key":"bib4","series-title":"Clinical Endocrinology","first-page":"411","article-title":"Testicular enlargement and elevated serum inhibin concentrations occur in patients with pituitary macroadenomas secreting follicle stimulating Hormine","volume":"31","author":"Helseltine","year":"1989","unstructured":"Helseltine DWhite MCKendall-Taylor PDe Krester DM & Kelly W. Testicular enlargement and elevated serum inhibin concentrations occur in patients with pituitary macroadenomas secreting follicle stimulating Hormine. Clinical Endocrinology198931411\u2013423. (https:\/\/doi.org\/10.1111\/j.1365-2265.1989.tb01265.x)"},{"key":"bib5","series-title":"Case Reports in Endocrinology","first-page":"Article ID 194716","article-title":"Testicular \"hyperstimulation\" syndrome: A case of functional gonadotropinoma","volume":"2014","author":"Thakkar","year":"2014","unstructured":"Thakkar AKannan SHamrahian APrayson RAWeil RJ & Faiman C. Testicular \"hyperstimulation\" syndrome: A case of functional gonadotropinoma. Case Reports in Endocrinology20142014Article ID 194716. (https:\/\/doi.org\/10.1155\/2014\/194716)"},{"key":"bib6","series-title":"Cancer","first-page":"613","article-title":"The prevalence of pituitary adenomas: a systematic review","volume":"101","author":"Ezzat","year":"2004","unstructured":"Ezzat SAsa SLCouldwell WTBarr CEDodge WEVance ML & McCutcheon IE. The prevalence of pituitary adenomas: a systematic review. Cancer2004101613\u2013619. (https:\/\/doi.org\/10.1002\/cncr.20412)"},{"key":"bib7","series-title":"World Neurosurgery","first-page":"900.e7","article-title":"Gonadotroph adenoma with secondary hypersecretion of testosterone","volume":"80","author":"Chamoun","year":"2013","unstructured":"Chamoun RLayfield L & Couldwell WT. Gonadotroph adenoma with secondary hypersecretion of testosterone. World Neurosurgery201380900.e7\u2013900.11. (https:\/\/doi.org\/10.1016\/j.wneu.2012.11.069)"},{"key":"bib8","series-title":"JAMA","first-page":"516","article-title":"Diagnosis and treatment of pituitary adenomas: a review","volume":"317","author":"Molitch","year":"2017","unstructured":"Molitch ME. Diagnosis and treatment of pituitary adenomas: a review. JAMA2017317516\u2013524. (https:\/\/doi.org\/10.1001\/jama.2016.19699)"},{"key":"bib9","series-title":"Journal of Ophthalmic and Vision Research","first-page":"187","article-title":"Visual fields at presentation and after trans-sphenoidal resection of pituitary adenomas","volume":"6","author":"Dhasmana","year":"2011","unstructured":"Dhasmana RNagpal RCSharma RBansal KK & Bahadur H. Visual fields at presentation and after trans-sphenoidal resection of pituitary adenomas. Journal of Ophthalmic and Vision Research20116187\u2013191."},{"key":"bib10","series-title":"Brain Tumor Pathology","first-page":"5","article-title":"New WHO classification of pituitary adenomas (4th ed.): assessment of pituitary transcription factors and the prognostic histological factors","volume":"35","author":"Nishioka","year":"2018","unstructured":"Nishioka H & Inoshita N. New WHO classification of pituitary adenomas (4th ed.): assessment of pituitary transcription factors and the prognostic histological factors. Brain Tumor Pathology20183557\u201361. (https:\/\/doi.org\/10.1007\/s10014-017-0307-7)"},{"key":"bib11","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1089","article-title":"Clinical review 45: Clinically nonfunctioning pituitary adenomas","volume":"76","author":"Katznelson","year":"1993","unstructured":"Katznelson LAlexander JM & Klibanski A. Clinical review 45: Clinically nonfunctioning pituitary adenomas. Journal of Clinical Endocrinology and Metabolism1993761089\u20131094. (https:\/\/doi.org\/10.1210\/jcem.76.5.8496297)"},{"key":"bib12","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"4423","article-title":"Clinical review: Functioning gonadotroph adenomas","volume":"99","author":"Ntali","year":"2014","unstructured":"Ntali GCapatina CGrossman A & Karavitaki N. Clinical review: Functioning gonadotroph adenomas. Journal of Clinical Endocrinology and Metabolism2014994423\u20134433. (https:\/\/doi.org\/10.1210\/jc.2014-2362)"},{"key":"bib13","series-title":"Neurosurgery","first-page":"823","article-title":"Functional gonadotroph adenomas: case series and report of literature","volume":"79","author":"Cote","year":"2016","unstructured":"Cote DJSmith TRSandler CNGupta TBale TABi WLDunn IFDe Girolami UWoodmansee WWKaiser UB, et al.Functional gonadotroph adenomas: case series and report of literature. Neurosurgery201679823\u2013831. (https:\/\/doi.org\/10.1227\/NEU.0000000000001188)"},{"key":"bib14","series-title":"Pituitary Disorders","article-title":"Follicle stimulating hormone and luteinizing hormone secreting tumors","author":"Khazai","year":"2013","unstructured":"Khazai BSwerdloff RS & Wang C. Follicle stimulating hormone and luteinizing hormone secreting tumors. Pituitary Disorders2013. (https:\/\/doi.org\/10.1002\/9781118559406.ch11)"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2024\/1\/EDM22-0322.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2024\/1\/EDM22-0322.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2024\/1\/EDM22-0322.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:01Z","timestamp":1784555281000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3789"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":14,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.1530\/edm-22-0322","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,1]]}}}